Covid-19 Update Aggie Physician

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maroonbeansnrice
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In reply to BiochemAg97 • 6:35a, 4/13/20
AG
And to drill down on your last point, but if we don't have most people voluntarily identifying, then it won't do much good.

If I'm infected I'm going to stay home and not go near anyone...or if I'm bad off its pretty easy to find me in the ICU...and only the docs and nurses are coming near me (hopefully) lol. But I guess there are people that have to work that might be asymptomatic/have a mild case? They are single with no friends/family and have to get some groceries or go to the pharmacy? And we're expected to be okay with mingling with them and being advised of proximity after the fact? With gloves and a mask being de riguer everywhere we go? Yeah, this is a tough nut to crack, and I'm with you on not seeing the value/on the fence on this one for now.
“It ain’t like it used to be.”
-Jimbo Fisher
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Aggie09Derek
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7:15a, 4/13/20
AG
https://medium.com/the-weekend-reader/the-tank-and-the-motorcycle-6dd444eaa833

Long but well worth reading
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JYDog90
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In reply to BiochemAg97 • 7:17a, 4/13/20
AG
This seems like the most efficient way to get back to some semblance of normal. I'd do it
Formerly Willy Wonka
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BiochemAg97
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In reply to maroonbeansnrice • 7:44a, 4/13/20
AG
maroonbeansnrice said:
And to drill down on your last point, but if we don't have most people voluntarily identifying, then it won't do much good.

If I'm infected I'm going to stay home and not go near anyone...or if I'm bad off its pretty easy to find me in the ICU...and only the docs and nurses are coming near me (hopefully) lol. But I guess there are people that have to work that might be asymptomatic/have a mild case? They are single with no friends/family and have to get some groceries or go to the pharmacy? And we're expected to be okay with mingling with them and being advised of proximity after the fact? With gloves and a mask being de riguer everywhere we go? Yeah, this is a tough nut to crack, and I'm with you on not seeing the value/on the fence on this one for now.
The bigger issue is the time between when you became infectious and the time you got sick. Need to identify all the people you may have come in contact with the 2-3 days before you developed symptoms.

Hopefully, most people will take steps to prevent infecting other once they know they are sick.
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GaryClare
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In reply to AggieAuditor • 8:48a, 4/13/20
AG
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3rd Generation Ag
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9:15a, 4/13/20
AG
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

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shalackin
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9:33a, 4/13/20
AG
For one of the docs:

If the cough is "wet", does that lean more towards cold or some other ailment over covid?
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tmaggie50
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In reply to 3rd Generation Ag • 9:38a, 4/13/20
AG
3rd Generation Ag said:
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

Quarantine yourself if you want to. That's your choice. But the government shouldn't be able to tell me to lock myself in my home or that I cant go to work.
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GaryClare
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In reply to 3rd Generation Ag • 9:38a, 4/13/20
AG
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RM1993
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In reply to tmaggie50 • 9:41a, 4/13/20
AG
tmaggie50 said:
3rd Generation Ag said:
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

Quarantine yourself if you want to. That's your choice. But the government shouldn't be able to tell me to lock myself in my home or that I cant go to work.
Actually, the government has every right to tell you to lock yourself in your home and that you can't work. The government has broad sweeping powers in cases of national emergency.

How some people still don't get this simple fact is beyond me.
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BiochemAg97
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In reply to RM1993 • 9:48a, 4/13/20
AG
RM1993 said:
tmaggie50 said:
3rd Generation Ag said:
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

Quarantine yourself if you want to. That's your choice. But the government shouldn't be able to tell me to lock myself in my home or that I cant go to work.
Actually, the government has every right to tell you to lock yourself in your home and that you can't work. The government has broad sweeping powers in cases of national emergency.

How some people still don't get this simple fact is beyond me.


In the grand American experiment, the entire idea is the rights belong to the people and the power of the government flows from the governed. So the govt may have the power to lock you in your home, but does it necessarily have the right? Only in so far as most of the people are ok with it.

People have rights... governments have power.
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tmaggie50
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In reply to RM1993 • 9:49a, 4/13/20
AG
RM1993 said:
tmaggie50 said:
3rd Generation Ag said:
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

Quarantine yourself if you want to. That's your choice. But the government shouldn't be able to tell me to lock myself in my home or that I cant go to work.
Actually, the government has every right to tell you to lock yourself in your home and that you can't work. The government has broad sweeping powers in cases of national emergency.

How some people still don't get this simple fact is beyond me.
Slow down when reading. I said they SHOULDNT BE ABLE TO. Yes, they have the ability to do virtually anything they want to. This is not, in my opinion, a national emergency and would be a total abuse of power. But abuse of power is their specialty and many people seem to love it.
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John Francis Donaghy
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10:10a, 4/13/20
Not the place for this discussion.
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Stormchaser
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10:15a, 4/13/20
AG
Quote:
Not the place for this discussion.
Amen.
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fig96
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In reply to California Ag 90 • 10:33a, 4/13/20
AG
California Ag 90 said:
Big Al 1992 said:
Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
what is he basing this on? he states that we don't have widespread antibody testing but then speculates on antibody distribution based on what 'data shows'.

what data is he referring to?

i'm getting to a point that i don't and won't believe anything any epidemiologist says until we see widespread antibody testing. everything is conjecture until then.
This has all been conjecture since the get go. With no widespread testing everything about infection, mortality, etc. rates is just an educated guess.

That being said, I'm going to listen to the epidemiologist before the politician (on either side).
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Drip99
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10:40a, 4/13/20
AG
I keep hearing "we are all going to get this", "get it over with" and "herd immunity". That seems to be a problem if true in Texas. I live in Hays county pop 230k and currently 89 have tested positive (confirmed cases) in the whole county and only 3 cases in Dripping Springs where i live. Math tells you that we are light years away from anything resembling a herd and i assume hays is not the only county in this position. It would seem that opening everything up even to a minimal extent could cause an outbreak and crash the system in many places across the country. Obviously we need to get the economy running again but the decisions on how to do that while balancing the overall health impacts are going to be difficult.

How does the collective we develop herd immunity in places where cases have been kept at a minimum? How long would this take and would we be dealing with month or even a year of stress in the hospital system and health care workers in areas of the country where social distancing has kept the case count low?
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74OA
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In reply to emando2000 • 10:44a, 4/13/20
AG
emando2000 said:
Contact Tracing System

Do we really think this is the way to go?
Death is perfect privacy.

That's not the way I want to go.
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buffalo chip
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In reply to 3rd Generation Ag • 10:47a, 4/13/20
S
3rd Generation Ag said:
Sorry I am NOT signing up to die and my demographic dies when we get it. I have promises to keep and miles to go before I sleep.


it is easy for someone the right age and with the right blood type to say go ahead and just get it. We all don't have that as a good option. We need the time to get a proven treatment that works for the elderly with the wrong blood type.

So masks need to be a must and quarantine of active cases.

I understand the concern. I am what my granddaughters call a BOOMER. Posted below is an older (3/16/20) CDC article about mortality rates. For every age below 84, the case fatality rate percentage is below single digits, including all co-morbidity issues. For those 85 and above, the CFR for those who are infected ranges from 11% to 27% (I imagine increasing as you get older).

There are those infected by the virus who die in every age group, but there is not an age group where the demographic all die. Not even close...

https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
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Reveille
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In reply to Drip99 • 10:56a, 4/13/20
AG
JesusQuintana said:
I keep hearing "we are all going to get this", "get it over with" and "herd immunity". That seems to be a problem if true in Texas. I live in Hays county pop 230k and currently 89 have tested positive (confirmed cases) in the whole county and only 3 cases in Dripping Springs where i live. Math tells you that we are light years away from anything resembling a herd and i assume hays is not the only county in this position. It would seem that opening everything up even to a minimal extent could cause an outbreak and crash the system in many places across the country. Obviously we need to get the economy running again but the decisions on how to do that while balancing the overall health impacts are going to be difficult.

How does the collective we develop herd immunity in places where cases have been kept at a minimum? How long would this take and would we be dealing with month or even a year of stress in the hospital system and health care workers in areas of the country where social distancing has kept the case count low?
Well theoretically if the communities around you have herd immunity it will give some protection by not near as likely to bring the virus into your community. But it is certainly best to have your own community with herd immunity. A vaccine is a much better solution.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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OldArmy71
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In reply to buffalo chip • 10:58a, 4/13/20
AG
You're taking 3rd Gen a bit literally. This damn virus is very dangerous for people in their 70s.
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California Ag 90
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In reply to fig96 • 11:17a, 4/13/20
AG
fig96 said:
California Ag 90 said:
Big Al 1992 said:
Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
what is he basing this on? he states that we don't have widespread antibody testing but then speculates on antibody distribution based on what 'data shows'.

what data is he referring to?

i'm getting to a point that i don't and won't believe anything any epidemiologist says until we see widespread antibody testing. everything is conjecture until then.
This has all been conjecture since the get go. With no widespread testing everything about infection, mortality, etc. rates is just an educated guess.

That being said, I'm going to listen to the epidemiologist before the politician (on either side).
to clarify, i did not credit the opinions of politicians over epidemiologists.

my point is that all the speculation, which is all over the map from epidemiologists (from sewage analyses to projections from mutations of viral DNA, to mathematics on viral spread in different geographies that don't reconcile), is basically useless with this bug. i'm not believing any of it until we get broad random antibody samples of the populace.

don't draw me into the food fight over 'we're right and they're wrong'. the only thing i feel comfortable will prove correct when this is done is that EVERYBODY has been wrong to varying degrees, with staggering costs we will bear for a long time to come.

We're from North California, and South Alabam
and little towns all around this land...
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OldArmy71
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In reply to buffalo chip • 11:20a, 4/13/20
AG
I wish I could find a more recent version of those stats. I have looked everywhere but can't see anything more recent than those, which are a month old.
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fig96
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In reply to California Ag 90 • 11:25a, 4/13/20
AG
Not intending to put words in your mouth or draw you into an argument, not why I post here (unlike some). Sorry if it came off that way.

Just making the point that currently the epidemiologists are the best source of info we've got, though even there it's probably best to take in a range of opinions as they differ.
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California Ag 90
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In reply to fig96 • 12:18p, 4/13/20
AG
fig96 said:
Not intending to put words in your mouth or draw you into an argument, not why I post here (unlike some). Sorry if it came off that way.

Just making the point that currently the epidemiologists are the best source of info we've got, though even there it's probably best to take in a range of opinions as they differ.
understood - sorry if i'm quick on the trigger - the food fight aspect of the discussion about this drives me crazy.
We're from North California, and South Alabam
and little towns all around this land...
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buffalo chip
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In reply to OldArmy71 • 1:34p, 4/13/20
S
OldArmy71 said:
I wish I could find a more recent version of those stats. I have looked everywhere but can't see anything more recent than those, which are a month old.
I have tried. The CDC says that it is a weekly report, but that 3/16 date is the most recent data regarding age-related morbidity that I can find.
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emando2000
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In reply to 74OA • 2:56p, 4/13/20
AG
74OA said:
emando2000 said:
Contact Tracing System

Do we really think this is the way to go?
Death is perfect privacy.

That's not the way I want to go.

Lol, it's not privacy vs death.
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OldArmy71
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In reply to buffalo chip • 3:24p, 4/13/20
AG
Same here. Thanks for trying.
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Change Detection
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4:14p, 4/13/20
AG
Question for the doctors regarding Quercetin. My wife takesThyroid NP 45 MG. Will Quercetin interfere with this or impact/disrupt the Thyroid. We cannot tell through online write ups.







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Reveille
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10:33p, 4/13/20
AG
Today's update!

https://m.facebook.com/story.php?story_fbid=2668066593476281&id=1998386763777604?sfnsn=mo
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Reveille
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In reply to Change Detection • 11:08p, 4/13/20
AG
Change Detection said:
Question for the doctors regarding Quercetin. My wife takesThyroid NP 45 MG. Will Quercetin interfere with this or impact/disrupt the Thyroid. We cannot tell through online write ups.


Should not be an issue!
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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buffalo chip
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In reply to OldArmy71 • 11:13p, 4/13/20
S
OldArmy71 said:
Same here. Thanks for trying.
A whole load of morbidity stats from the CDC (link provided by another TA poster on one of the other threads):

https://data.cdc.gov/NCHS/Provisional-Death-Counts-for-Coronavirus-Disease-C/hc4f-j6nb/data

Two items stuck out to me:
1. When you look at deaths from all causes and deaths from COVID-19 within the three age groups that are 65 years of age or older compared to total deaths from all causes and from COVID-19, the results are almost the same. Covid 19 fatalities are age related, yes, but no more so (materially) than the age relation of deaths from all causes.

2. The total deaths from all causes seemed to go down every week since 3/1/2020. All of the stay at home orders have saved lives, from all causes (most likely from injuries, like car accidents) as well as from COVID-19.
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eric76
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In reply to Reveille • 11:17p, 4/13/20
AG
Reveille said:
Big Al 1992 said:
Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
That is probably very realistic and that would still be a huge number as only 0.17% has tested positive so far. If we have 10% that would definitely slow this disease down. It would not give us herd immunity as that will likely not occur to 60-70% but it would go a long way towards slowing the spread. Thus, making things significantly safer for many people. I am sure some statistics major could run the numbers on that. So that is not all bad, combine that with all we have learned about treating this virus and it should make you feel a little better.
I saw something that said that the acquired immunity we develop from some coronavirus that causes a cold is only temporary -- about 1 to 3 years. Would there be reason to expect more immunity from having this coronavirus?
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eric76
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12:36a, 4/14/20
AG
From http://www.npr.org/sections/goatsandsoda/2020/03/20/819038431/do-you-get-immunity-after-recovering-from-a-case-of-coronavirus:
Quote:
"Almost everybody walking around, if you were to test their blood right now, they would have some levels of antibody to the four different coronaviruses that are known," says Ann Falsey of the University of Rochester Medical Center.

After infection with one of these viruses, she says, antibodies are produced but then the levels slowly decline and people become susceptible again.

"Most respiratory viruses only give you a period of relative protection. I'm talking about a year or two. That's what we know about the seasonal coronaviruses," says Falsey.
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AtlAg75
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5:53a, 4/14/20
AG
For the Dr.'s I am curious if you see merit in the below hypothesis. This comes from a friend of mine, a retired Episcopal Bishop. He is working with some team re: Covid 19 but I'm not sure who that is. I apologize if it has already been discussed, I just missed it if so. Here is the hypothesis he sent -

One of the most interesting hypotheses is that covid-19 is not attacking the respiratory system directly, but rather through our blood system. Many of the earliest symptoms, and late stage disease issues suggest that hemoglobin is being shorn of iron. This produces two problems: one, iron enters the bloodstream as a toxic oxidized free radical which our immune system detects as an emergency situation and devotes its major resources to, and two, the hemoglobin loses its ability to carry oxygen and the body starts becoming oxygen depleted. These two potential occurrences produce symptoms and consequences that some doctors believe are clearly being seen in many, even most, covid-19 patients.

If this hypothesis is true, it means we have been misdiagnosing the subsequent disease that the covid-19 produces. But the good news is.....if this hypothesis is true, then there is a clear path to treatment.......HZA. Hopefully they can move quickly to validate or debunk this hypothesis.
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BiochemAg97
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In reply to Reveille • 7:36a, 4/14/20
AG
Reveille said:
Today's update!

https://m.facebook.com/story.php?story_fbid=2668066593476281&id=1998386763777604?sfnsn=mo
Another less helpful alternative is that the antibody tests may have poor specificity.

The math is interesting here. If you have a low level of positives in the population, the false positives from the large negative population can significantly skew the results. Let's assume a false positive of 5% and 10% of the population has antibodies. The ~10% will test true positive. Of the negative group, 5% will be false positive (5%*90%=4.5%). That results in the test showing positive 14.5% of the time and about a 3rd of the people that test positive are actually negative.

When you get to higher exposures, say 50%, then you have ~50% real positives and 2.5% testing positive but actually negative and the errors don't matter so much.

I chose 5% because the antibody test authorized in the US is slightly better than 95% specificity. However, there has been a lot of evidence of some very bad tests floating around, either from supplier fraud for Chinese sourced tests or just poorly designed/made tests.

Given that people tested positive before COVID19, it could be false positives or it could be cross reactivity as you mentioned in the post. And cross reactivity may be good or it may be bad. The cross reactive antibodies might cross react to the protein used in the test but not actually react to the virus, or the cross reactivity antibodies may produce a weak immune response. That weak immune response may not be sufficient to protect against the virus, and given the whole cytokine storm, insufficient immune response may trigger bad outcomes.
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